The Man Van: Mobile targeted case finding for prostate cancer.
Authors: Masood Moghul, Fionnuala Croft, Netty Kinsella, Declan Cahill, Nicholas D. James
Journal: Journal of Clinical Oncology (2023)

6522 Background: Early intervention is potentially lifesaving in prostate cancer. The debate for screening continues with recent developments suggesting the arguments in favour are becoming stronger however, barriers to access remain. The Man Van project is designed to address these with a highly novel community-based targeting of high-risk groups on a mobile unit. Methods: A bespoke mobile health vehicle was moved to 8 community-based locations in areas of high deprivation indices in London, UK, inviting men for a health check consisting of: general health questionnaires, blood pressure, height/weight, HbA1c for diabetes and a PSA test. Telemedicine was used to inform patients of outcomes. Direct referrals to secondary care was performed. Community engagement was utilised to increase uptake using: primary healthcare centres, religious organisations and community centres. Results: Between December 2021 and December 2022, 618 men were seen at our Man Van clinics at a range of community settings (non-attendance rate 24%). The highest uptake was in locations where there was collaboration with primary care to recruit patients. The median age of attendees was 56 years, range 25-87. 43% of attendees were non-white (20% black). The median BMI was 27.7, range 16.2-50.5. 422 PSA tests were performed with 14 prostate cancers (3.3%) found till date. 9 (64%) of these cancers were grade group 2 (all &gt; 5% pattern 4) or 3. Of patients diagnosed with prostate cancer the median age was 59 years, range 48-73, 10 were black (71%), median PSA 6.85 g/L, range 0.81-45, median IPSS score was 9.5, range 2-31, median IIEF-5 was 16, range 1-25. The IPSS score was significantly higher (P &lt; 0.05) in men diagnosed with prostate cancer. 1 bladder (G3pT1) and 1 oesophageal cancer (T3N2M1) were also found. 3 patients had either HGPIN or ASAP, 3 patients had renal stones, 2 urethral strictures were found. 334 HbA1c tests were performed with 18 diabetics diagnosed (5.4%). 46 patients (7.4%) required input for benign urinary symptoms and 20 for erectile dysfunction (3.2%). Primary care referrals were as follows: 171 for hypertension (27.6%), 43 for an elevated BMI (7.0%), 37 for mental health issues (6.0%), 43 for excess alcohol intake (7.0%), 51 for smoking cessation assistance (8.3%). Significantly more patients 45 years were referred for primary care follow-up versus &lt; 45 years (P &lt; 0.01). Service evaluation questionnaires showed overwhelmingly positive support for the service. Conclusions: The Man Van initiative is a novel method of linking primary and secondary care for a range of health checks, including PSA. By improving community awareness and access in high-risk groups we demonstrate high uptakes for health checks including for prostate cancer and a willingness to engage with health improvement measures. As well as comparatively high levels of prostate cancers diagnosed at early stages, high levels of other health conditions were found; improving the economic value of the service.